Riganò R, Profumo E, Ioppolo S, Notargiacomo S, Ortona E, Teggi A, Siracusano A
Laboratorio di Immunologia, Istituto Superiore di Sanità, Roma, Italy.
Clin Exp Immunol. 1995 Nov;102(2):281-5. doi: 10.1111/j.1365-2249.1995.tb03778.x.
The relation of interferon-gamma (IFN-gamma), IL-4, IL-10 production and specific IgE, total IgG, IgG subclass expression to the effectiveness of pharmacological treatment in human hydatid disease (Echinococcus granulosus infection) was evaluated in 27 hydatid patients divided into four clinical groups according to their response to albendazole/mebendazole therapy (full, partial, low and non-responders). After parasite antigen stimulation, peripheral blood mononuclear cells (PBMC) from full responders produced significantly more IFN-gamma (P = 0.038), significantly less IL-4 (P = 0.001) and less IL-10 than PBMC from non-responders. PBMC from partial and low responders produced intermediate cytokine concentrations. ELISA determining immunoglobulin production showed that sera from all non-responders had IgE and IgG4 antibodies, both regulated by IL-4. In contrast to IgG4, IgE decreased rapidly in full responders. Full responders also showed the highest percentage of IgG3 reactions. Qualitative analysis of total IgG responses in hydatid patients' sera determined by immunoblotting showed that binding profiles to hydatid cyst fluid antigen differed in the four groups of treated patients. Non-responders had the highest percentage of reactions to all subunits of antigens 5 and B, and full responders had the highest percentage of reactions to antigen 5 alone. The high IFN-gamma production associated with a lack of IL-4 and low IL-10 production in the full responders, and vice versa the high IL-4 and IL-10 production associated with lack of or low IFN-gamma production in the non-responders implies Th1 cell activation in protective immunity and Th2 cell activation in susceptibility to hydatid disease. IgE may be a useful marker of therapeutic success in hydatid patients with pretreatment specific IgE antibodies. IgG subclass responses and differential immunoglobulin subclass binding pattern to hydatid antigens may also be useful in the immunosurveillance of hydatid disease.
将27例包虫病患者根据其对阿苯达唑/甲苯达唑治疗的反应（完全缓解、部分缓解、低反应和无反应）分为四个临床组，评估了干扰素-γ（IFN-γ）、白细胞介素-4（IL-4）、白细胞介素-10的产生以及特异性IgE、总IgG、IgG亚类表达与人类包虫病（细粒棘球绦虫感染）药物治疗效果之间的关系。在寄生虫抗原刺激后，完全缓解者的外周血单个核细胞（PBMC）产生的IFN-γ明显更多（P = 0.038），产生的IL-4明显更少（P = 0.001），且产生的IL-10比无反应者的PBMC少。部分缓解者和低反应者的PBMC产生的细胞因子浓度处于中间水平。ELISA法检测免疫球蛋白产生情况显示，所有无反应者的血清中均有IgE和IgG4抗体，二者均受IL-4调节。与IgG4不同，IgE在完全缓解者中迅速下降。完全缓解者还表现出最高比例的IgG3反应。通过免疫印迹法对包虫病患者血清中总IgG反应进行定性分析表明，四组接受治疗的患者与包虫囊肿液抗原的结合谱不同。无反应者对抗原5和B所有亚基反应的比例最高，而完全缓解者仅对抗原5反应的比例最高。完全缓解者中高IFN-γ产生与低IL-4和低IL-10产生相关，反之，无反应者中高IL-4和高IL-10产生与低IFN-γ产生或缺乏IFN-γ产生相关，这意味着在保护性免疫中Th1细胞被激活，而在包虫病易感性中Th2细胞被激活。对于治疗前有特异性IgE抗体的包虫病患者，IgE可能是治疗成功的有用标志物。IgG亚类反应以及对包虫抗原的不同免疫球蛋白亚类结合模式在包虫病的免疫监测中也可能有用。
